June 8, 2005
Woman Has Child After Receiving Twin's Ovarian Tissue
By DENISE GRADY
A 25-year-old woman who had been unable to have children gave birth to a
healthy daughter on Monday night in Alabama, about 15 months after receiving
a transplant of ovarian tissue from her identical twin sister.
The new mother, Stephanie Yarber of Muscle Shoals, Ala., is the first woman
to have a baby after an ovarian tissue transplant from another person, her
The birth does not open the door to widespread use of ovarian transplants to
cure infertility, at least not immediately, doctors said.
Ms. Yarber had no need for antirejection drugs, because her sister was a
perfect match genetically. In women who are not identical twins, drugs would
be needed to prevent rejection. The drugs can have harsh side effects, which
would raise ethics questions about the procedure, because unlike other organ
transplants it is not necessary to save the recipient's life.
"But one day, no doubt, the rejection problem will be overcome and we won't
need the drugs, or we won't need them for long," said Dr. Roger G. Gosden, a
professor of reproductive biology at Weill Medical College of Cornell
University and a member of the team that treated the sisters. "Then the
procedure could be used very widely, and will replace a lot of conventional
The transplant was performed last year at St. Luke's Hospital in St. Louis
by Dr. Sherman J. Silber. The surgery is described in an article that The
New England Journal of Medicine released on its Web site yesterday and that
will be published in its July 7 issue.
A spokeswoman for the journal, Karen Pedersen, said the editors had accepted
the article on the condition that a healthy baby would be born and planned
to release it as soon as the birth occurred.
Dr. Silber said the fact that transplanted ovarian tissue could produce a
healthy child offered hope to women with cancer who must undergo
chemotherapy that would damage their ovaries and leave them infertile. Those
women could have their own ovarian tissue removed and frozen before starting
chemotherapy, and then transplanted back when the cancer treatment was
finished and they were well again.
Last September, researchers in Belgium reported the first birth of a child
as a result of that procedure, but there was some skepticism about the case
because the doctors had removed only one ovary from the patient, and it was
not clear whether her pregnancy came from the transplanted tissue or from
the ovary that had been left behind.
"I think this is absolute proof of concept that they can get pregnant," Dr.
Ms. Yarber was unable to have children because, for unknown reasons, she
reached menopause at age 14. She stopped menstruating after just a few
cycles, and her ovaries and uterus were shrunken, like those of a
But her twin sister,Melanie Morgan, was fertile, and the mother of three
children. Initially, Ms. Morgan donated eggs so that Ms. Yarber could try in
vitro fertilization. Ms. Yarber had eggs implanted in her uterus twice, but
did not become pregnant. At that point, the sisters consulted Dr. Silber.
He removed one of Ms. Morgan's ovaries through a tiny incision, stripped off
the outer layer, which contains the eggs, and cut it into thirds. He sewed
one strip to each of Ms. Yarber's ovaries, and froze the third for possible
About six months later, Ms. Yarber became pregnant naturally, without any
drug treatment or further surgery. The hormones produced by the transplanted
ovarian tissue made her uterus enlarge to a normal size. Her daughter,
weighing 7 pounds, 14 ounces, was born naturally.
"Stephanie should be able to have many more babies this way," Dr. Silber
He added that it was almost certain that the pregnancy came from the
transplanted tissue and not from her own ovaries, because she had no eggs
He and Dr. Gosden described Ms. Yarber's history. A spokeswoman for St.
Luke's said that the sisters were not available for interviews on Tuesday,
and a phone call to the Yarber residence was not returned.
Dr. Gosden and Dr. Silber said that when they began treating the two
sisters, they thought it would be rare to find a set of identical twins in
which one was fertile and the other not. But since then, they have
encountered other pairs, and learned that infertility is about five times as
common in identical twins as in the rest of the population. Doctors do not
know why. There may be hundreds of such cases in the United States, Dr.
"We just did our third ovarian transplant between identical twins today,"
Dr. Silber said. "We think there'll be a lot more."